ࡱ> cgb[ bjbjmm j"bbj &&&&&$>&>&>&P&&>&g&L ' ' ' ''''!g#g#g#g#g#g#g$i\l^Gg&'''''Gg&& ' '\gC*C*C*'F& '& '!gC*'!gC*C*1cf 'PĀ +(ve6 grg0gKeVm(mlfm&fl''C*'''''GgGgC*'''g''''m'''''''''B $: CHECKLIST FOR VOLUNTEER MINOR STUDENTS and/or INDEPENDENT RESEARCH STUDENTS PARTICIPATION IN UNIVERSITY LABORATORIES There are times when the utilization of Volunteer high school students or minor students doing independent research in University laboratories is mutually beneficial to the University and the students. It offers talented students the opportunity to observe and participate in research activities before they enroll in college. It affords the university additional exposure to its research and scientific endeavors. This checklist outlines the requirements that must be met before the P.I. and/or laboratory manager (if appropriate) can admit minor (under age 18) students into their laboratories. Written confirmation that Department Chairperson acknowledges and approves of the activity described below. P.I./Laboratory Manager (if appropriate) provides a description of the work activities the student will be engaged in. University Safety & Assurances (USA) reviews and approves before a letter is prepared for the students parent(s). An action plan (to be reviewed by USA) shall be developed by P.I. or Lab Manager that outlines the activities of the student and provides the following safeguards: Description of the orientation and training the student will receive prior to any work in the lab Plan for the P.I./Lab Manager supervision of the student Indicates that the student will not have key access to the lab P.I. or Lab Manger prepares a letter for the students parent/guardian that outlines the students duties, activities etc. The letter should include the following (see sample letter as example): Include a description of the activities the student will be involved in Include a description of any hazardous materials the student may be working with Include a statement of supervision and training Include a statement regarding professional liability coverage (used only for volunteers) The following attachments should be included with the letter to parents: Safety data sheets for the chemicals the student may use in the laboratory Confirmation of Assumption of Risk, Indemnification and Release and Parental Consent fully executed by the parents(s) or guardian Photo release form to be signed by the minor students parent(s) or guardian Self-Addressed and Stamped Envelope The HYPERLINK "http://www4.uwm.edu/secu/docs/other/S_64_Child_Abuse_Neglect.pdf"Child Abuse and Neglect Policy training has been completed by all members of the lab and documented The "HYPERLINK "http://www4.uwm.edu/secu/docs/other/S%5F75%5FMinor%5FProt%5Fship%5FPolicy%2Epdf"Minor Protection and Adult Leadership Policy" is required in all cases where minors are involved in activities at 51 or affiliated with 51 functions. This policy is intended to protect the adults that are in contact with children. Contact  HYPERLINK "mailto:riskmgt@uwm.edu" Risk Management for more information on this policy.  HYPERLINK "http://www4.uwm.edu/hr/pde/compliance/cbc.cfm" Criminal Background Checks have been completed on all members of the lab and documented Include a copy of this completed checklist and documentation for the file     Rev. 5/2015 tvP Q  4 N m  :t'Ih!"nopԽԎh<hT^CJaJhmX$CJaJh<hmuz0J3CJaJ#jh<h8lCJUaJh8lCJaJjh<hmuzCJUaJh-$WCJaJh<hmuzCJaJh<hWy\CJaJh<h]xCJaJh]x h]x5\/uv A - 5 n r ;( )$ & Fxa$gd< ($ & Fxa$gd< ($ & Fxa$gd< '$ & Fxa$gd<'$ & F xa$gd< '$ & Fxa$gd<$a$ jlmoprsuv1gdWy\'$ & F xxa$gd<'$ & F xa$gd< )$ & Fxa$gd<678dejs,-QRab JiļļĭĭĘĉ~l_~TIh<hWy\CJaJh<h]xCJaJh<hmuz0J3CJaJ#jh<hmuzCJUaJh<hmuzCJaJjh<hmuzCJUaJh<CJaJh<hT^0J3CJaJjh<hT^CJUaJhmX$CJaJh<hT^CJaJhmX$hmX$0J3CJaJj hylCJUaJhylCJaJjhmX$CJUaJijkmnpqstvw{|}hbBhmuzh}CJaJhmuzCJaJhmuzhmuzCJaJhjhUh<h]xCJaJ3...()()()..)() 0P/ =!"#$% 8$Dp3????????()()() 0P/ =!"#$% 8$Dp DyK yK http://www4.uwm.edu/secu/docs/other/S_64_Child_Abuse_Neglect.pdfyX;H,]ą'cDyK yK http://www4.uwm.edu/secu/docs/other/S_75_Minor_Prot_ship_Policy.pdfyX;H,]ą'cDyK yK thttp://www4.uwm.edu/hr/pde/compliance/cbc.cfmyX;H,]ą'c6s02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH D`D Normal1$7$8$H$_HmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List r/r 1AutoList4,$ 01$7$8$H$^`0a$CJ_HaJmH sH tH v/v 2AutoList4/$ 01$7$8$H$^`0a$CJ_HaJmH sH tH x/x 3AutoList42$ pp01$7$8$H$^p`0a$CJ_HaJmH sH tH |/"| 4AutoList45$ p@ @ 01$7$8$H$^@ `0a$CJ_HaJmH sH tH ~/2~ 5AutoList48$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /B 6AutoList4;$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /R 7AutoList4>$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /b 8AutoList4A$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH r/rr 1AutoList3,$ 01$7$8$H$^`0a$CJ_HaJmH sH tH v/v 2AutoList3/$ 01$7$8$H$^`0a$CJ_HaJmH sH tH x/x 3AutoList32$ pp01$7$8$H$^p`0a$CJ_HaJmH sH tH |/| 4AutoList35$ p@ @ 01$7$8$H$^@ `0a$CJ_HaJmH sH tH ~/~ 5AutoList38$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 6AutoList3;$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 7AutoList3>$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 8AutoList3A$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH r/r 1AutoList2,$ 01$7$8$H$^`0a$CJ_HaJmH sH tH v/v 2AutoList2/ $ 01$7$8$H$^`0a$CJ_HaJmH sH tH x/x 3AutoList22!$ pp01$7$8$H$^p`0a$CJ_HaJmH sH tH |/"| 4AutoList25"$ p@ @ 01$7$8$H$^@ `0a$CJ_HaJmH sH tH ~/2~ 5AutoList28#$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /B 6AutoList2;$$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /R 7AutoList2>%$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH /b 8AutoList2A&$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH rorr 1AutoList1,'$ 01$7$8$H$^`0a$CJ_HaJmH sH tH vov 2AutoList1/($ 01$7$8$H$^`0a$CJ_HaJmH sH tH xox 3AutoList12)$ pp01$7$8$H$^p`0a$CJ_HaJmH sH tH |/| 4AutoList15*$ p@ @ 01$7$8$H$^@ `0a$CJ_HaJmH sH tH ~/~ 5AutoList18+$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 6AutoList1;,$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 7AutoList1>-$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH / 8AutoList1A.$ p@ 01$7$8$H$^`0a$CJ_HaJmH sH tH 44 0Wy\Header / H$.. /Wy\ Header Char4 @4 2Wy\0Footer 1 H$.!. 1Wy\0 Footer Char6U`16 muz Hyperlink >*B*phHBH 5muz Balloon Text4CJOJQJ^JaJN/QN 4muzBalloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w<   5! 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